INDICATORS

Typically, national health information systems compile data from several sources
based on national data gathering routines. These data sources regularly produce a large
amount of data that are usually distributed to a number of agencies and institutes.
The processing and analysis is performed in diverse organisational structures, usually
under the responsibility of different authorities. The integration and rationalisation of
this fragmented information and the underlying distributed data sources is one of the
key issues that has to be resolved in the development of a national health information
system. The following table presents the most typical national data sources for health
indicators as well as their main advantages and drawbacks.
Table 1. Most typical national data sources, their advantages and drawbacks.
Data source Advantages Drawbacks
Mortality and
causes of death
registers
Cancer registers
Other disease
registers
Registers on
functional
limitations
Hospital
admission/
discharge
registers
Primary care
registers (general
practice)
Obligatory data collection,
Excellent coverage,
reasonable validity.
Excellent coverage, good
validity. Often incidence,
case fatality and survival
data.
May have good coverage
and validity, such as
infectious diseases register.
Incidence data.
In principle, important
information may be
available in some registers
of disabled people and
persons entitled to social
security benefits.
May have excellent
validity for both patients
and treatment of major
diseases.
Reasonable validity for
patients and causes of visits
in some countries with
comparable health systems.
Relate only to the end point of disease and
injury.
Poor EU comparability since coverage
and record linkage possibilities vary (data
protection restrictions).
Cover only diagnosed cases of a few
diseases. No problems with incidence,
but prevalence not reflected. Differences
in health systems may affect coverage and
validity.
Registers often have poor coverage, and
they are system dependent. Comparability
between countries is poor.
Cover only hospitalised patients; may
not allow individual level linkage for
true incidence. Varies by health system.
Private care not necessarily covered. Not
possible to distinguish between suspected
and confirmed diagnoses. Over-reporting
of severe cases possible, if reimbursement
system is related to diagnosis and
procedures.
System dependent; coding systems
differ, making comparisons difficult. The
information can only be related to the
whole population in a few EU countries.
Private care not necessarily covered. Not
possible to distinguish between suspected
and confirmed diagnoses. Over-reporting
of severe cases possible, if reimbursement
system is related to diagnosis and
procedures.
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